Upper Airway Resistance Syndrome (UARS) and Empty Nose Syndrome (ENS): Are They Connected?

[@unstablecat]

ENS was already well known about 70+ years ago.

[@timcepin3386]

I had no idea.

[@yuppystick]

Not by this guy lol

[@Padoinky]

In 2008 I had my deviated septum repaired along w/ turbinate reduction, removal of my tonsils and a uvulectomy and it’s been a tremendous success - I definitely wasn’t the happiest person for about 2wks post-op, but since then, my breathing has improved, my sinusitis and ear infections have abated and my obstructive sleep apnea has been eradicated….

[@Supriyatin08]

Do you now have no problems sleeping and breathing?

[@healthyisbeautiful8720]

Dr. Park I had what can be considered a “conservative turbinate reduction “ cut and cauterized unfortunately. It took a long time to figure why I felt so horrible after surgery. Don’t blame more cases of ens on internet, maybe doctors are doing more surgeries now than ever before. Any patient that goes to ent for congestion gets the same formula…”deviated septum, enlarged turbinates; surgery is NECESSARY. Greed is the root of the proliferation of ens cases.

[@doctorstevenpark]

Healthy is Beautiful, sorry to hear about your experience. Unexpected outcomes occur for every type of surgery, no matter how rare. The point of my video is that ENS reports are growing despite much more conservative turbinate procedures. And as a result, nasal surgery can be suboptimal. I also provide a possible reason why people with ENS feel worse after surgery. To generalize ALL nasal surgery as being rooted in profits is taking it a too far. What about the tens or hundreds of thousands of patents who have benefited from nasal surgery and are breathing much better with no complications? I agree, there are some patients that can be managed with non-surgical options, but people who go on to surgery usually have exhausted all these options. I'm not discounting ENS at all. In fact, I see objective reasons why people with ENS suffer, beyond the nose. There is a way of treating ENT with implants that can help sometimes. Did you ever look into this? I hope you are able to find answers to your health issues.

[@healthyisbeautiful8720]

Thank you for your response Dr. Park. Yes, I have looked into all the options to treat ENS. Implants can be tricky. Some people develop more problems with the implants on top of ens. I did have injections that could mimics the effectof implants without positive results. Were are you located? I would like to have a consultation with you to explore your theory about ENS

[@doctorstevenpark]

@@healthyisbeautiful8720 I agree that the implants are not always the right answer. Unfortunately, I am no longer in practice. I do have a virtual coaching option, which I link to below.

[@marklewis9061]

I ended up with terrible symptoms after only a conservative turbinate reduction via radiofrequency and a septoplasty. I strongly disagree that the internet is to blame for ens cases showing up a lot more now so than years ago. ENS cases never get reported and patients are always pushed away when it happens. You know this is true. Implants are not the answer. We need a multi-million dollar research project involving regenerative medicine to help us with this terrible situation caused by these surgeries and you know it.

[@marklewis9061]

Are you saying nerve damage is not possible inside the nose Dr. Park? And damage to the nasal mucosa is not possible? 😂 wow. I never went to school and I even know this

[@KhalKhtri]

Coming from a family of health professionals, they all agree that Ent's only scratch the surface when it comes to fully understanding the complexity of the nasal turbinates. The only justifiable reason to do any surgery would be for a life threatening condition,birth defect, or trauma.

[@chazlon5061]

what about a septoplasty for trouble breathing?

[@doctorstevenpark]

As an ENT, I do agree with you to a certain point. Addressing the turbinates only will give suboptimal results, since the septum and nostrils are also usually involved. Most people who have chronic nasal congestion have facial under-developmental, which narrows the nasal and throat airways. This is why you see that young people today have more triangular and narrow faces. This by definition will cause nasal congestion, along with being more predisposed to allergies due to many environmental and dietary reasons. So for people who can't breathe despite trying everything the doctor gives them, surgery is an option. But it has to be done properly and comprehensively. Not a minimal "scratching" procedure. Cancer is another common reason to perform turbinate surgery. I commented before that people who undergo major nasal sidewall surgery for what's called inverted papilloma (middle and lower turbinates and nasal sidewall removed) don't get ENS, as far as I know. There are also may dietary, toxic, prescription medication reasons for enlarged turbinates and nasal congestion. In the end, they all cause autonomic dysfunction. Sometimes, dietary change alone can take care of nasal congestion, but not all. And in certain cases, surgery may be needed to give someone a head start, in addition to dietary and lifestyle changes.

[@chazlon5061]

@@doctorstevenpark what kind of dietary changes will help?

[@doctorstevenpark]

@@chazlon5061 There's no specific diet for ENS, but I generally recommend dietary/lifestyle changes to address issues that cause the metabolic syndrome in modern countries: Low-carb/high good fat, no seed oils, minimize toxins in home and personal care products, and lots of sunlight with Vit D levels > 60 (most will need to supplement with vitamin D3 + K2MK7). Unfortunately, there's no diet that's going to help UARS and ENS if you're still obstructing during sleep. This has to be addressed separately. I have other videos on UARS on my channel.

[@roberttyrrell2141]

Is it primarily the turbinate surgery that can cause this condition? How about ESS without turbinate reduction ?

[@cebruthius]

I am a UARS survivor, though self-treatment with BiPAP at first, and ASV later. Before I started treatment, my nose was a disaster. I remember that I couldn't breathe through my nose *at all* during my first sleep study. When I started BiPAP the PS overcame a bit of nasal resistance and I started to sleep better. Quickly, my nose completely opened up. I can now do intense cardio, breathing nasally and all without ever having to have any nasal intervention. I wonder how many people are like me, but are denied effective xPAP treatment (BiPAP mostly)

[@teethree141]

i feel the same. It feels like I am suffocating

[@Enter.nic-]

Does BiPAP really help to sleep how many hours it provide better sleep

[@cebruthius]

@@Enter.nic- Before BiPAP I was a vegetable. When I first tried the BiPAP in CPAP mode I had nonstop panic attacks for an hour. Fortunately I could just turn on the BiPAP mode and I fell asleep instantly. I've been using it 100.0% since, I love my machine.

[@Enter.nic-]

@@cebruthius thanks for your kind response

[@yahyaelmi8435]

@@cebruthiuswhere did you buy it ? Online ?

[@msgesus4518]

I was told I would recover in 10 days post turbinate reduction, I couldn't sleep for more than half an hour at a time for about a month. Slowly I have recovered after about 1 year mark, but it never helped with sleeping, in fact I have a harder time breathing in the winter now, and in the office or any air conditioned environments. That's the worst part, my nose will crust on the inside and bleed often, and it feels like I can't breath until I rinse or pick it out when it gets dry.

[@independenceclothing3219]

have you got nerve pain?

[@msgesus4518]

@@independenceclothing3219 not pain, more dry and numb

[@independenceclothing3219]

@@msgesus4518 Could you guide me in knowing why I feel pain? I have been told that it could be pain in damaged nerves, but most people who have empty nose syndrome do not have pain

[@msgesus4518]

​@@independenceclothing3219 I'd talk to your ent. Not sure sorry I'm not a dr.

[@mick12495]

Dr. Park, what Upper Airway Resistance Syndrome (UARS) treatment options are effective for treatment of ENS? BiPAP, ASV, diet, lifestyle changes? What did you find the most effective treatment option?

[@teethree141]

I had ENS symptoms last yr. Couldn't feel the sensation of air through my nose at allll. Just had a maxillary palatal expansion with a starting inter molar width of 30 mm, now at 35 mm. Can now feel air through my nose. Wow. life changing.

[@aryanchettri2251]

You mean you expand the sinuses?

[@KhalKhtri]

Not buying it

[@teethree141]

lol im not selling anything. so why is there to buy -_- @@KhalKhtri

[@teethree141]

@@aryanchettri2251 actually I started at 32 mm inter molar width. and now at 38.5. I expanded my upper palate and nasal cavity. It's called the MIND procedure. I will say that I still have nasal resistance (nasal valve collapse), but I can now feel the sensation of air through my nose. My next step is to fix my nasal collapse. Not sure how to do it because Im scared of empty nose syndrome.

[@aryanchettri2251]

I see. What type of surgeon did for you

[@colinbarnerj3a]

“As far as I know, there have been no reports…” The question is, who is doing the official reporting?? Definitely no one who actually has empty nose syndrome, that’s for damn sure.

[@The-Edge-NL]

I suffer from ENS now 14 years , this year I will get implants……. Due to turb reduction fess operations I have to much tissue loss to much air chronic dryness, pain inflammation no resistance can’t handle cold air always headaches this all started after my nose surgery’s so don’t touch the nose only when it is life treathning

[@cyrils.1194]

Super interesting thanks !

[@Denp296]

Hello Dr. Park, do you have experience with patients who did bilateral inferior turbinate reconstruction with autologous costal cartilage , do symptoms improve?

[@razerbsaa5034]

Doctor i am suffering empty nose syndrome due to resection of turbinate they cut off like 50% of the volume. i wanna know if PRP injection can help grow back mucosal??

[@snap8353]

Hey do you want to try something really useful? Just listen to me.. Go to allergy doctor and just get allergy test.. Ever allergic substance to your body will most likely be an allergic substance to your nose, bring and sniff every allergic substance to your body.. Pollen or smoke or dust.. The say is the test.. Two weeks and I promise you runny nose and enlarged turbinates

[@independenceclothing3219]

have you got nerve pain?

[@razerbsaa5034]

@@independenceclothing3219 no only felling pain when i breath

[@Enter.nic-]

Have you taken any treatment

[@AnkitSharma-hr6rl]

Sleep problem

[@jacquesmertens3369]

You can't talk about ENS without saying which turbinate is involved. Lower? Middle? Upper? Superior (in rare cases)? Most of the nerve endings are in the middle and top section. Nerve damage could easily explain ENS. Are there any reliable statistics on the involvement of the lower turbinate in ENS vs middle and upper turbinate?

[@muhammadamsari4082]

Have you experienced it? I did it 1 month ago with my 2 turbinates. But after the healing process and seeing with a camera that my turbinates grow normally again, can I be at risk of developing ENS? What symptoms do ens sufferers experience? Sorry if I ask too many questions because I'm afraid of ens. And I hope your answer can help me

[@jacquesmertens3369]

@@muhammadamsari4082 My question was for the owner of this channel. I have not experienced it myself. However: I think you have no reason to worry because 1 month has already passed and everything is fine. That means there isn't any nerve damage and therefore you can't develop ENS. Your surgery was successful.

[@muhammadamsari4082]

​@@jacquesmertens3369But now I feel my breath feels cold and dry. My sleep time is also disturbed, I often wake up without it and it happens 4-5 times a night 24/7, I feel it. I'm afraid of en & I'm very sorry if that happens because I just got married and just had children. I'm very afraid of that

[@jacquesmertens3369]

@@muhammadamsari4082 If your surgeon says your turbinates grow back you should consider yourself lucky. It's exceptional for that to happen. I understand your fear and anger because maybe you should not have had the surgery, or maybe they should have removed less. But if there is regrowth your symptoms of cold air should improve. Keep praying for regrowth to undo the damage. God bless.

[@muhammadamsari4082]

​@@jacquesmertens3369OK, thank you for your prayers and support.. At that time I removed some of my turbinates but I don't know what percentage they removed. I'm scared because on Mellow Mike's KZbin channel, he only had 10% of his turbinates removed and he's suffering from ENS.. I'm really scared of that

[@nicholastsaclas2619]

Until the surgeon incorporates nasal cytology as part of a comprehensive workup to fully understand potential complications before any nasal surgery I would think twice about proceeding with a surgical procedure.

[@timcepin3386]

How can you tell if someone is going to develop ENS or not?

[@kittycat8222]

I have been diving into this. As my son’s ent wants him to have it done. I have read that no matter the procedure (cutting, needle energy etc) that if the turbinate nerves are damaged in any way it can cause it. It’s a nerve to the brain that signals that air is moving through the nose to give you breath. Freaky. So we won’t do it most likely. Too many stories of people wanting to be dead

[@dannprairie9202]

Please doctor, I have had an empty nose for 2 years, I don't know why, I haven't had any surgery. Do you know something natural, or any medicine, exercise, that can help me recover the turbinates? Thank you

[@doctorstevenpark]

Dann, your situation supports my theory that many of the symptoms of ENS are due to UARS, even if you don't have had any turbinate surgery. It's difficult for any ENT to make any recommendations without examining you in person, but from what I've seen, most of the symptoms in ENS is due to autonomic nervous system imbalance. Not only in the nose but systemic (all over your body). So anything that will help calm your nervous system will help, but only so much. Making a major change to your diet is another option, such as going on a low-carb or even Keto diet. There are literally dozens of other recommendations you'll see on KZbin, but they all help only to some degree, since they never address the root causes. Any there are many causes which are not treated in most cases. My bias is that most modern humans have small faces, which means your airway will be smaller. Not to the point of having sleep apnea, but still waking up subconsciously many times every night. I talk about various ways to deal with poor breathing and sleep in my other videos. Good luck!

[@JReiAtsu]

me too..i have atrophic rhinitis and the symptoms are very similar to ENS :( i have trouble sleeping

[@sergiomejia4555]

@@JReiAtsu what do you do for sleeping

[@sergiomejia4555]

@Doctor Steven Park can you share the links to the videos

[@spiiral]

​@@doctorstevenpark how can we restore ANS balance?

[@riccvven2078]

Ens with quantum resonance, Hell

[@timcepin3386]

Why do some people get it right after surgery and why do some people develop it afterwards?

[@independenceclothing3219]

try to find out a possible solution with a good cosmetic surgeon. If they perform a bilateral osteotomy of the nasal bones and the nasal dorsum is lowered a little, the turbinates will automatically be close to the septum since as they arise from the walls of the nasal bones, as they narrow, the nasal cavity becomes smaller. That way you should improve the air pressure and feel the flow. At the same time, the humidity should improve a little.

[@abrawelyi7713]

hey doc I did septoplasty surgery about two years ago now my life is change for worst because of it. I can't sleep at night if I try I will wake up gusping for air and sufication. what can you do to help please get back to me I can't work anymore from luck of enegy I have three young kids to rise. I am the only person working to provide. please get back to me I know you must be busy but please try.

[@doctorstevenpark]

So sorry to hear about what you're going through. As I pointed out in my video, any kind of surgery besides turbinate surgery can also sometimes make things worse. This can happen by improving or even worsening nasal airflow. For example, if your nose is more stuffy, you'll tend to open your mouth, which will narrow the airway in your throat, aggravating more breathing problems. If your nasal breathing improves, the increase in airflow can also aggravate more throat tissue collapse. My recommendation for someone in your situation is to first go back to your surgeon to make sure everything is healing well with your surgery. In the meantime, some people have found help using nasal dilator strips or internal devices to open up the nostrils, as well as to add mouth taping (see my other video on this). The next step is to see a sleep doctor to see if you have obstructive sleep apnea. Good luck, and please keep us posted.

[@abrawelyi7713]

thank you so much for your respond. I will try those recommendations update you if helps me or not. as mean time I am using cpap machine on 4 helps me alots but it dry my nose and eye. I also use Qtip folded in half helps me just little bit. be our voice ans let as know what helps other some sautiation. God bless you!!

[@snap8353]

@@abrawelyi7713 sir what's happening with you now?

[@Micksmix256]

Ive had 4 nose surgeries and cant figure out whats going on with me. They tell me my noae is striaght as an arrow, i went to one of the top specialists in my state and had a corrective septoplasty, latera implants, turbinate reduction, FESS... clarifix.... still getting a bunch of bubbly mucus, constantly swallowing. Seems to be worse when my natural nasal cycle closes up the affected side. I feel like im losing my mind.

[@Micksmix256]

The side i had turbinate reduction on is also smooth and deep like a valley. Ive been told my a lot of drs that a lot of turbinate tissue was removed. 4 doctors have said no thanks to more surgery. Trying hard to pinpoint the issue

[@morm2173]

Also septal spur deviation and perforation is a fear

[@Reecieboi1985]

Hi there , hope your doing well ,I had septoplasty with a spur on the left side , Killian's incision , deviated cartilage and spur removed. Cartilage kept back. Right side inferior turbinate submusocal diathermy done 11 days ago and came across about ENS and I'm petrified that I might end of getting ENS , I have been diagnosed with obstructive sleep apnea last year and been using a CPAP machine, I'm so worried I have made a mistake with this surgery , is there anything I should be looking out for? My nose is congested with nasal crusting struggling to have a good night sleep.

[@yahyaelmi8435]

How are you feeling now ?

[@mikevhoekk]

Don't worry about that, the man says it's extremely rare

[@muhammadamsari4082]

How many times do you wake up during sleep at night?

[@Lander76]

Hi Doc, can turbinate outfracture cause ens?

[@gautambehera5451]

Do u treat ens ?

[@doctorstevenpark]

I"m not in practice anymore. There are only a handful of doctors in that US that I'm aware of who treat ENS. Dr. Houser has published his results on ENS. Here's his video: kzbin.info/www/bejne/ZmjNqpJtntxnmsk

[@Enter.nic-]

Have you taken any treatment?

[@timcepin3386]

Coblation is not conservative!

[@putraganteng1881]

Im not good in english but i want to share my story .I had turbinate reduction for about 4 month, i live with my voices before, i mean , i sing to gain money. But now i dont know why, i cannot hit If the note is too high, and after i sing i feel tension in my head, and also my sinus. It feel dry and crusty, i still can sleep 6 to 7 hours but sometimes i can’t sleep at all, and i feel worse after the surgary.. im still looking for how diet can heal me.. i hope healthy diet can help me , or the turbinate regnarate by healthy food 🥺

[@independenceclothing3219]

have you got nerve pain?

[@putraganteng1881]

@@independenceclothing3219 ye i have and it was realy bad

[@muhammadamsari4082]

​@@putraganteng1881How is your breathing now? I hope you are much better

[@muhammadamsari4082]

​@@putraganteng1881apa kamu dari indonesia?

[@putraganteng1881]

@@muhammadamsari4082 im still struggling with this contition, i jave dry nose , several pain in may nos, lack of sleep because of i don’t feel the air come in

[@eljefe2211]

I had almost all my.turbinates removed The only issues i have is occasional dryness, strange bafkward airway snort Ens is made up

[@Наверное-щ5р]

Are you feeling any suffocation?

[@ftfggjggojfishhihidt8308]

How are you feeling you now?

[@eljefe2211]

I feel great still have bad allergies But since i had my turbinates removed it no longer becomes blocked My case was different as i had severe allergies so all my turbinates had to be removed To be honest my nose feels empty sometimes and i have had that suffocation but not anymore

[@yorocco1]

1. We suffocate; tends to make you emotional. 2. 20% is not a small risk. 3. Studies support extensive nerve damage in victims. Please keep up with the research before you post content.

[@davidandrew2429]

Hi do you have any research papers? I am suffering from volume loss due to turbinate reduction through coblation. I would like to warn other people about this

[@KhalKhtri]

Suffocating/smothering from ENS is a classic sign of neural pathways that become compromised from the injuries sustained from these useless procedures. Terms parroted by I'll informed ENTs such as emotional, depressed, "anxiety" only minimize the severity of the neurological and physical impact ENS has on the human body. I do concur with everything else you mentioned.

[@yorocco1]

@@davidandrew2429 I’m sorry, I just saw this. I’m not a medical doctor, I am a professor. If you go to Pub Med you will find many studies investigating the cause and effect of damage to the Inferior Turbinates and resultant Empty Nose Syndrome.

[@js_guyman]

​@@yorocco1I asked in an ENS group about data regarding how often ENS occurs from turbinate reduction. I was told the incidence data is unknown. Where did you get the 20% from?

[@timcepin3386]

How much volume?

[@mindofmayhem.]

I suspect it's a new drug being used that wasn't around long ago.

[@rd2071]

No

[@akshaythakur9702]

Doctor I never had surgery on nose but I lost my air sensation from last 9 months my symptoms suffocation drowing sensation and numbness in nose...please reply doctor what damage I got from this steroids nasal drops and sprays please reply doctor

[@danishsaifi8389]

Hello bhai I am also facing these problems...!!

[@danishsaifi8389]

U visited any doctor .

[@rd2071]

Spammer

[@juliejulie1702]

Hi did any of u find out the reason ? Was it the nasal spray?

[@juliejulie1702]

Hi , how long did u used the sprays and drops for before u noticed the symptoms?